Incidence — and fear — of dementia increase with life expectancy

Far from abating Americans’ concerns about Alzheimer’s disease, public awareness of the disease has increased fears for many. According to a 2010 survey by the MetLife Foundation, people over 55 dread getting Alzheimer’s more than any other disease. Although 93 percent were aware of the disease, almost three-quarters say they know very little or nothing about Alzheimer’s.

We do know that the disease is unprecedented, the repercussions pervasive, the impact profound and the effects enduring. We can only hope that increased knowledge about Alzheimer’s will alleviate some of the anxiety.

Of the more than 100 types of dementias, the four main types are irreversible. These include Alzheimer’s disease; vascular dementia; Lewy bodies, and frontotemporal dementia.

Other less common dementias result from head injury and trauma; tumors; pressure of fluid in the brain; bacterial and viral infections; toxic, endocrine and metabolic causes; chronic alcoholism; and lack of oxygen. Whatever the cause of the disease, the effect on the brain is the same. It begins with a gradual and progressive reduction in the number of living cells in the brain. The brain slowly begins to die.

Some potentially reversible causes of dementia — although a small proportion — include medication side effects, thyroid or excess vitamin B12 deficiency, abnormal calcium levels and abscesses in the brain.

The greatest risk factor in dementia is age, and as Americans live longer, the threat of Alzheimer’s will continue to increase. The Alzheimer’s Association estimates that 4.5 million Americans now have dementia. It further affects more than a third of U.S. adults through a family member or friend who has Alzheimer’s. Three out of five people surveyed were concerned that they may someday have to be a caretaker for someone with Alzheimer’s. Although eight out of 10 people said they think it is important to plan ahead for the possibility of getting Alzheimer’s, they have taken no steps to prepare for the possibility of Alzheimer’s.

Apart from staying healthy, eating a balanced diet and generally staying mentally active, few options exist for stopping dementia. It is a degenerative disease that progressively weakens the capacity to function.

As a community, we still have not learned how to deal with this disease. The fear that cancer engendered is being replaced by “dementiaphobia.” The very word dementia inspires a degree of fear that “heart attack,” “stroke” or even “kidney failure” often do not. Any of these conditions can kill. Yet somehow, to many of us, the idea of dementia seems more horrifying. Perhaps we fear the idea of losing who we are — becoming a stranger in an unfamiliar body.

The unknown fuels fear. If you are one of the majority who has signs of dementiaphobia, start by finding family members or friends who have early stage dementia and talk with them. Converse. Keep the discussion simple, be patient and show compassion. You will be amazed how successful you will get at learning how to communicate differently. The fear will subside, maybe not completely diminish, but you will be able to see the disease without any emotional baggage.

Mario Garrett, Ph.D., is a professor of gerontology at San Diego State University and can be reached at mariusgarrett@yahoo.com